Topics Frequently Asked Questions Search:  
  1. Explain the process of taking a patient photo at registration.
    Answer:
    1. After filling in all the details required on the registration form, click Save. (Because
      a photo can be attached only to an existing patient record).
    2. The "Clip (Attach)" button near the Photo heading now gets enabled.
    3. Check that the digital camera setup is ready and connected to the computer.
      Start the digital camera software. Set the folder where the clicked images should be
      saved.
    4. Now take the patient's photograph using the digital camera software.
    5. If prompted by the digital camera software for a file name, accept the default name and accept the default file type. To conserve space, the recommended format is .jpeg, which is 20 times smaller in size than .bmp using appropriate digital imaging software such as "MS Paint". The recommended image size is a width of 220 pixels and a height of 200 pixels.
    6. Now click on the "Clip (Attach)" button near the Photo heading.
    7. A window pops up. Click on the Browse button.
    8. Now select the folder and the image file (the patient photo just clicked) from it and click Open.
    9. To view the photo, click the "Lens" button beside the Browse button.
    10. The photo is seen in the window below it.
    11. If OK, click the Attach button or reselect the appropriate photo.
    12. Clicking the Attach button attaches and saves the photo.
    13. Close the alert pop-up by clicking OK. This also closes the attach photo pop-up.
    14. The photo file is now uploaded to the application server at the location:
      "\prognocis\prognocis2\datafiles\patientphoto" with a system-defined name.
    15. The registration form window is now seen with the photo attached.

    Note: The registration window may show the photo area with scrollbars if the photo size is larger than the designated area (220 x 200 pixels). Once a photo is attached, the original image saved by the digital camera software is no longer required and can be deleted. If the attached image is not appropriate, the user may attach an image again; the old image on the server will be overwritten with the new image.
  2. Explain the process of taking pictures of a patient in the exam room.
    Answer:
    1. Click on the Pictures option in the Encounter menu.
    2. Check that the digital camera setup is ready and connected to the computer.
    3. Start the digital camera software. Set the folder where the clicked images should be saved.
    4. Now take the picture(s) of the patient's affected area using the digital camera software.
    5. If prompted by the digital camera software for a file name, accept the default name and accept the default file type (to conserve space, the recommended format is .jpeg, which is 20 times smaller in size than .bmp using appropriate digital imaging software such as "MS Paint").
    6. Click Add New.
    7. A window pops up. Click on the Browse button.
    8. Now select the folder and the image file (the patient picture just clicked) from it and click Open.
    9. To view the photo, click the "Lens" button beside the Browse button.
    10. The photo is seen in the window below it.
    11. If OK, click the Attach button or reselect the appropriate photo.
    12. Clicking the Attach button attaches and saves the photo.
    13. Close the alert pop-up by clicking OK. This also closes the attach photo pop-up window.
    14. The photo file is now uploaded to the application server at the location:
      "\prognocis\prognocis2\datafiles\pictures" with a system-defined name.
    15. Repeat Steps 6 to 14 to add more pictures.
    16. The pictures window is now seen with the pictures attached.
    17. To enter comments for a picture, click on that picture.
    18. A pop-up window opens.
    19. Click on the area of the picture to place the pin there.
    20. Now, enter comments (adding predefined phrases is also possible by clicking the Search button and selecting the desired ones from the pop-up) in the area provided below it.
    21. Click OK to save the comments.
    22. The doctor can now draw on the pictures and also view a slideshow of all the images.

      Note:       The picture size must be restricted to 455 pixels in height and 560 pixels in width. Photos larger than this size will be truncated when shown to place pins.
      When all pictures are shown on the main page, they are scaled down depending on the number of rows & columns and the available real estate; as such, there could be some distortion.
  3. Explain the process of scanning and attaching Lab results, viewing them, and using them in a transcript.
    Answer:
    1. Start the scanning software.
    2. Set the folder where the scanned image should be saved.
    3. Scan the copy of the Lab result.
    4. When prompted for a file name, accept the default name and accept the default file type (recommended .jpeg).
    5. If there is more than one page, scan all of them with the default name and save them in the same folder (path given above).
    6. After all of the pages are scanned, open a new Word document.
    7. Insert all the scanned images of the pages from the folder in Step 2.
    8. Save it under a name you wish.
    9. Go to Lab Results and click on the Attach tab to attach the above Word document file.
    10. Click Save.
    11. The file is now uploaded to the application server at the location:
      "\prognocis\prognocis2\datafiles\labresult" with a system-defined name.

      Note: Only one file can be attached to a Lab Result. In case the result comes in as a single page, it is not necessary to copy this scanned image into a Word file. This image file can be directly attached to the results.
  4. A doctor needs to be reminded that results pertaining to the last encounter need to be reviewed now (although he had approved them a few days earlier). How and where do we accept his review comments?
    Answer:
    On the Encounter TOC, the Lab Result and Rad Result options display the count of orders that are yet to be reviewed. This way, the doctor is reminded that he has to review the results received. What is not obvious, though, is whether all of the Pending for Review orders were from the last encounter, or if a few of them have been pending for a longer time. Lab Results has a field to accept one common review comment for all completed but not reviewed Lab Orders. This field is invoked in a pop-up window from the Lab/Rad Results screen. This is invoked only if the user (Doctor or Nurse) goes to the Results screen from the Encounter TOC (Lab/Rad Result) option (not from CPOE > Lab Results).
  5. When we click on the TOC Lab Order, what elements are shown when the logged-in user is a Doctor, Nurse, or other role?
    Answer:
    Lab/Rad Order invocation from the CPOE main menu:
    If the logged-in user is a Doctor:
    He can edit and view all orders where:
    He is the Ordering Doctor AND
    the Order Status is Entered, Approved, or Ordered.

    If the logged-in user is a Nurse:
    She can edit and view all orders where:
    the Order Status is Entered, Approved, or Ordered.
    The Nurse has access to all orders, irrespective of the Ordering Doctor. She gets a Selection List Box on the toolbar to select orders for a selected doctor.

    Other users are not expected to have access to this option. If they have the rights, they will be treated as a Nurse.

    All orders are shown in Search (and the Next and Previous buttons) in descending order of the Lab/Rad Order Number. Note that the Order Number is generated. Each Doctor can have a different prefix. If the logged-in user is other than a doctor, this can create a problem to the extent that the latest generated Order will not be at the top of the search list. A good solution is to have a single prefix for the clinic, rather than one specific to each Doctor.
    Order Lab/Rad Invocation from the Encounter TOC:
    All orders that belong to the current encounter, irrespective of their order status.
  6. If a nurse is ordering Lab tests, what happens to the Doctor's Preferred Tests?
    Answer:
    The test selection is done through a Lab Test search. Hence, when a nurse logs in to create a Lab order, she can view the Attending Doctor's preferred Lab Tests.
  7. Can a panel test be hidden? Can a test included in a panel be hidden?
    Answer:
    No. If it is a panel, the value in the Hide check box is not considered. The Hidden flag is applicable only for Both and HL7 Order Tests. A test included in a panel can be hidden. Hidden does not imply that the test is no longer in use. It just means that since it is part of a panel, do not show it explicitly in the test selection list again.
  8. What happens if a panel constituent test's hidden status is changed after each Lab Order action (Save, Approve, Send, Receive Results, Complete)? Will it affect the Transcript?
    Answer:
    There is no problem. If changed before sending, the Order Selection list will show or hide the test.
  9. Rule for keeping the Comments button enabled/disabled in a Lab Order?
    Answer:
    The button is normally enabled. Once Approved, comments cannot be modified. But how does anyone know if there are any comments? So once approved, if there were no comments entered, it will be disabled; otherwise, it will remain enabled. However, on opening the Notes screen, the OK button will be disabled so that no changes can be made.
  10. Why is a doctor's entry editable but not HM in PHS?
    Answer:
    The doctor enters tests explicitly; hence, he has the right to change them. When he prescribes a drug, say, to reduce the blood sugar, he may advise the patient to check the blood sugar every week. He does this by scheduling this test. In all such cases, the frequency will be of short duration, typically in days.
  11. What is the rule for the default Sig/Route/Frequency?
    Answer:
    The user can select drugs from the Doctor's Preferred list, or the list of all drugs. The system maintains the last used Sig/Route/Freq/Days for both, and these are shown by default. Since the system knows from which list the drug details came, on clicking Save, it updates the corresponding list with the current details.
  12. What is the formula for computing the Issue Quantity?
    Answer:
    Issue Qty = Sig * Freq * No. of Days
  13. Where does the default pharmacy in Rx come from?
    Answer:
    The pharmacy selected in the prescription of each encounter of a patient is stored in the Encounter Master. The last used pharmacy is also stored in the Patient Master. The next time any doctor writes a prescription for the patient, the default pharmacy comes from the Patient Master.
  14. Is it possible to print Rx separately for OTC, Prescribed, and DEA-restricted drug categories?
    Answer:
    No. There is no filtering on the type of drugs. However, as per the requirements in many states, it is possible to print Rx separately for each drug. To do this, the user has to ensure while designing the Prescription template that the first line is the Tag [SEC_RX_DET_START] and the last line is the Tag [SEC_RX_DET_END].
  15. Give the consolidated list of validations made when closing an encounter.
    Answer:
    Only the Attending Doctor can close an encounter.
    All Lab/Rad Orders, prescriptions, and Letters-Out pertaining to this encounter must also be completed. The system tracks and provides the documents for the current encounter that are Entered, Approved, and Sent.
    Consider the flag in Settings > Configuration > Properties > enc.close.orderstatus. If it is set to A, the count of Entered documents must equal the count of Approved documents. If it is other than A, the count of Entered documents must equal the count of Sent documents.
    If the Encounter Type has an Appointment Duration > 0 (i.e., it is other than a Refill Request or Telephone encounter) and Billable is true,
    If enc.close.Icd.must is Y, then an Assessment ICD is mandatory.
    If enc.close.Enm.must is Y, then an E&M code is mandatory.
    Consider the values in Settings > Configuration > Properties > enc.close.checkifdone. The system checks for all the specified options and warns the user about the modules that have not been completed.
    The value in Settings > Configuration > Properties > enc.close.letterprompt is considered. Accordingly, if a letter to the referring doctor has not been sent for that particular encounter, the system generates a warning message offering to internally generate a letter and send it to the referring doctor.
  16. What are section tags? Where and how are they used?
    Answer:
    The section tags serve the purpose of printing Lab Orders, Rad Orders, Prescriptions, and Encounter Reports. All of these logically consist of printing one common Header/Footer and printing a number of detail lines or transactions. For example, in a Lab Order, we need the Clinic, Patient, Doctor, and Lab Name/Address, etc., as part of the header. The details of each test to be printed become part of the transaction record. There can be any number of transaction records in a Lab Order. Except for this small conceptual difference, programmatically order printing is in no way different from Progress Notes generation. So we add a simple rule: the program will ensure that all tags between the corresponding Section Start and Section End tags are processed for each transaction record; all other tags are processed only once. Thus, in our example of a Lab Order, when designing the template, keep the tags for test details between SEC_LAB_DET_START and SEC_LAB_DET_END; other tags (for header/footer) can be placed before or after them.
    It should be easy to guess the purpose of the following and to use them in their respective templates only.

    SEC_LAB_DET_START Lab Order Tests Start
    SEC_LAB_DET_END Lab Order Tests End
    SEC_RAD_DET_START Rad Order Tests Start
    SEC_RAD_DET_END Rad Order Tests End
    SEC_RX_DET_START Rx Order Drugs Start
    SEC_RX_DET_END Rx Order Drugs End
    SEC_ENC_REP_START Encounter Report Start
    SEC_ENC_REP_END Encounter Report End